Center for Elder Care and Advanced Illness

Older couple sitting on park bench Vision

To help the United States achieve social arrangements that ensure that, when we must live with serious chronic illnesses associated with advancing age, we can count on living meaningfully and comfortably, at a sustainable cost to our families and society.

Making it Safe to Grow Old: Better Care for Frail Elders

Our current health care system, developed to treat and cure acute illness and injury, is not-prepared to care for the age wave. Even as we face an opportunity to learn from aging adults and their experiences of long life, we face the challenge of supporting millions likely to experience ongoing, chronic diseases that lead to disabling and eventually fatal illness. Demographics and increased longevity will challenge American ingenuity and resourcefulness in years to come: We face burgeoning numbers of dependent elderly; diminishing numbers of family caregivers who have limited resources; and a health services and delivery system that cannot meet their needs. Instead of making continuity, comprehensiveness, and caregiver support a priority that dysfunctional system focuses on short-term outcomes from costly and often ineffective medical interventions. The Center for Elder Care and Advanced Illness (CECAI) aims to create the fundamental changes needed to build a compassionate, effective, affordable, trustworthy system.

What Are Our Core Strategies for Addressing This Work?

  • Designing and implementing demonstration projects in communities nationwide, with a particular focus on optimizing care transitions and continuity of care for frail elders as they move within the care system;
  • Reshaping the framework in which we consider, design, and deliver care for frail elders, recognizing that this aim will require a profound change in how we organize such care, and a shift to making that care more locally controlled and monitored;
  • Developing, studying, and improving comprehensive care plans for frail elders, plans that go beyond the typical  retrospective list of medications and problems, and expand to consider the likely future and preferred approach
  • Promoting and informing public perspectives and dialogue on specific, innovative approaches to improving systems and services and addressing cost; and,
  • Advocating to inform and guide leaders as they shape policies that will affect all of us--and the people we love--as we age. 

Where Are We Now?
Since our launch two years ago, CECAI has sharpened its focus, while building on several key concepts. Through community-based work nationwide, and with public and private funds, we are working with cutting-edge groups to improve  how the society conceives of and responds to the challenges of late life. Based on our early studies of how to improve care transitions across health care settings, we now work with communities seeking to apply community-mobilization approaches to create change, galvanize systems, and engage family caregivers.  Among our many activities, recent projects have included:

  • Working with thought leaders to reframe how to envision the lives and experiences of frail elders, and using this perspective to develop policies and responses that promote a better quality of life, and increased community control.
  • Supporting community efforts to improve patient care across settings (e.g., from hospital to home). Such error-prone care transitions are particularly difficult in current systems. The Center now helps scores of communities nationwide to respond to this Centers for Medicare and Medicaid initiative and move to create seamless, comprehensive care.
  • Building a stakeholder network capable of analyzing issues quickly and thoughtfully, and, when appropriate, responding to calls for public comment on proposed federal regulations.
  • Writing a book that characterizes our approach to care of frail elders, using social media strategies to engage a reader advisory panel.
  • Publishing ideas, findings, and commentary in an array of professional and lay publications, both in print and on line, and including the Journal of the American Medical Association, The Washington Post, and The New York Times.
  • Exploring strategies to build a volunteer Caregiver Corps, modeled on the Peace Corps, and engaging volunteers young and old to serve older adults and their families in their own communities, thereby building an eldercare workforce, providing meaningful community-service opportunities, and promoting intergenerational respect.

Why Altarum?
Altarum is a nonprofit research and consulting organization with decades of experience modeling, managing, and evaluating systems change in health care. Altarum has repeatedly demonstrated the expertise, credibility, partnerships, and resources required to tackle the most difficult and pressing issues that affect human health.

How Will the Center’s Work Contribute to Broader Systems Change?
No single organization will be able to prevent or resolve the looming crisis of an aging America. However, CECAI is convinced that solutions are to be found by catalyzing key improvements fundamental to progress in the quality, structure, delivery, and financing of care for this phase of life. In particular, the Center will:

  • Frame issues and choices in ways that are uncompromising, well researched, objective, and helpful to progress;
  • Share what we learn—the Center’s and those of others—to engender creative conversation and lead to modeling and testing of alternative approaches;
  • Build the public will for comprehensive and pragmatic solutions, making it appealing for political leaders to take on these topics in thoughtful and effective ways; and
  • Develop and deploy an effective Web-based platform and social media outlets to support the field as it works to change and improve the course of aging in America. 

Center Director Dr. Joanne Lynn, a geriatrician, health services researcher, clinical improvement advisor, and policymaker with a distinguished history of service to frail elders, and a lifelong commitment to finding practical ways to improve health and health care at a sustainable cost. Her methodological expertise, including rapid-cycle quality improvement as well as quantitative and qualitative study methods, means that the Center’s work will be reliable, practical, and sustainable

The Center has attracted a number of talented, skilled, and experienced experts, including Anne Montgomery and Jim Lee.

Products and Services
The Center produces products and services for clinicians, policymakers, and the public, such as:

Handbook For Mortals Cover Photo

Handbook for Mortals: Guidance for People Facing Serious Illness. Recipient of the 2012 American Medical Writers Association award for a book for the general public, this book provides clear and compassionate guidance for patients and caregivers faced with a serious illness that will lead to death. Readers will find practical recommendations for the words that they can use and the actions that they can take to ensure comfort, meaning, and dignity for this phase of life. The book is made personal with the inclusion of photos, poems, and quotations that help humanize difficult issues. • This website provides practical and widely available resources to help make it "safe to grow old," with frequent posts to update its blog, and other information and referral services. 

On-the-ground or online consulting and coaching from Dr. Joanne Lynn and her team of experts. 

Contact Information
To learn more about the ongoing work of the Center for Elder Care and Advanced Illness, please email or phone 202-776-5100. Additional information about the Center’s work is also available at or on Twitter @Medicaring.

For general information about Altarum, contact Ken Schwartz at